I've never written about health care reform here before, partly because it's not an issue I've ever been too concerned about, and partly because I never thought of it as an issue of Christian environmentalism. But as I've watched this debate gain heat over the last few weeks, culminating last night in the president's speech, I'm beginning to change my mind. Health care may not be an environmental issue, although it certainly overlaps. But it is a Christian issue.
My biggest concern after hearing the speech--and, I suspect, many people's biggest concern--is the question of how Obama plans to pay for the changes enacted in this bill. He claims it can be done mostly through savings and without adding any new taxes, other than allowing some tax cuts to run out. I'm neither an economist nor a legislator, but it seems counter-intuitive to me: something this expensive costs money, and governments get money from taxes. That's just the way they work. Government is a non-profit.
And the objection that I've heard over and over again to this plan is the financial aspect. "Why should MY money go to pay YOUR health care?" is the complaint I've heard over and over. And that is where the Christian aspect of this issue comes to the forefront, so that is the question I want to address. Why SHOULD your money pay for someone else's health care?
Do I really need to answer that question?
Hasn't the Bible answered it for me? In passages like Psalm 82:3: "Defend the cause of the weak and fatherless." And Proverbs 14:21: "Blessed is he who is kind to the needy." Proverbs 22:16: "He who oppresses the poor to increase his wealth and he who gives gifts to the rich--both come to poverty." Isaiah 1:17: "Seek justice, encourage the oppressed. Defend the cause of the fatherless, plead the case of the widow." Matthew 19:21: "Jesus answered, If you want to be perfect, go, sell your possessions and give to the poor, and you will have treasure in heaven. Then come, follow me." I John 3:17: "If anyone has material possessions and sees his brother in need but has no pity on him, how can the love of God be in him?"
How indeed.
Oh, you say, but I want to give money to the poor. I DO give money to the poor. I just want to choose where to give it. I give to my church and to charitable organizations that help provide health care to the poor.
Great. You get a tax deduction on that giving. You don't have to pay twice for other people's health care.
Which brings me to taxes. Americans hate taxes. America was practically founded on a hatred of taxes. I can understand this--I don't like taxes either. I've always believed that government should be as local as possible. But the reality is that private charity isn't covering the need. It isn't solving the problem. It isn't working. And if something isn't working--if there are children dying of preventable diseases--then something needs to change.
And I think the real problem with the argument that so many people make is right there in the question about "my money" going to pay for "your health care."
Because, if you claim to be a Christian, then you ought to believe it's not really your money. In fact, if you look at what Jesus said about taxes, you could argue that it's not even God's money. Jesus said it was Caesar's money. And our bills have pictures of presidents on them too.
By the way, I have health care. Really good health care from a private insurer, supplied at very low cost to us by my husband's job. My coverage is so good that when I go to the doctor, the receptionist always comments on how good my plan is. "Wow," she'll say, "your copay is really low! And you have no deductible! You have a great plan."
And--I'm almost ashamed to admit this, because it's so unfair--but the truth is we don't even need such great care. I've gone to lots of doctors who don't accept any health care and who aren't covered by my plan, but we could afford that. We were able to pay for that. We are nothing like the thousands of people in this country who can't afford to pay for any care at all, let alone paying to choose specialty care.
And so my response to the president's speech is heartfelt. Yes, pass your plan. Offer universal health care. And if you can't cover the cost with spending cuts, then please, raise my taxes to help pay for it. Use "my" money to pay for someone else's health care. I'll consider it money well spent.
Thursday, September 10, 2009
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What a fun topic! I have strong opinions in this area as you may have guessed. First, the main issue that needs to be addressed is from a legal standpoint: individuals need to have ownership legally of their care, not the doctors as long as the care provided is done in good faith and with accepted practice/execution. This will help to mitigate the cost of malpractice insurance (a decently significant cost of care) but more importantly go to reduce the cost of defensive medicine which is the great driver of medical costs today. Why when my child checked into the hospital with a minor fever did they insist on trying to hold him overnight and run spinal taps when they didn't have the skill to even do a spinal tap? Defensive medicine. Second, ban prescription advertising. Ok, maybe ban is strong, but there is no need to advertise your newest drug to the public at a cost of millions of dollars. Then have doctors write prescriptions not for specific drugs but for the generic drug ingredients such that the patient can decide when looking at the costs whether to take a name brand or generic drug. Don't provide any government money for any name brand drugs if there is a generic alternative. Third, provide free medical school from government coffers for all doctors (or doctors who commit to government run clinics or something of the sort) who can qualify. Then cap out the pay of these government doctors at $150K or something which will further help reduce the cost of medicine- free education in exchange for less pay. Fourth, provide completely free clinics/hospitals out of state moneys with these government doctors which provides a bare minimum of care for all preventative and emergency care. No long term care for terminally ill, no cutting edge technologies, no 20% chance of success procedures. Fifth, pass the "Medical Pricing Transparency Act" as I call it that makes all doctors say up front what they intend to check for, the cost of the procedure, and the odds of it working/addressing the issue. The consumer can then reject any procedures that are too expensive or low odds. Sixth, this sounds basic, but force hospitals/doctors to charge everyone the same price for the same procedure- gas stations can't do differently and neither should those in medicine. Finally, let the rest of the healthcare industry do whatever it wants and work out the kinks in the remainder of the market. The private hospitals will provide the long term care, the cutting edge procedures, the expensive care etc. The cost of the government system could probably almost be paid for by the reductions in Medicaid/Medicare costs from the other provisions, but a small tax should pick up the rest.
Justin, thanks for all the great ideas! I just have to say a word about defensive medicine and malpractice suits, because I think there are a lot of false opinions on this topic. I believe they could be almost entirely prevented by very simple measures. Making it harder to sue, legally, would not be as effective as making it psychologically less likely that patients would want to sue.
I read a study recently (in Blink) about the statistics of malpractice suits. In this study, psychologists were actually able to predict which doctors would be sued by watching forty seconds of doctor-patient interaction. They took out the high frequency sounds so the psychologists could hear the doctor's tone of voice but couldn't distinguish the words. And simply from the doctor's tone of voice, they could predict which doctors were going to be sued. Why? Because the doctors who sounded patronizing were the ones who got sued. And that was the closest statistical correlation in this study. The number of malpractice suits have NO statistical correlation with actual medical mistakes.
There is another correlation, however, which is how much time a doctor spends with each patient. Longer times with patients mean fewer suits. And it make sense. Everybody's human, and everybody makes mistakes. Patients know that doctors are human too. People don't sue because of a medical problem; they sue because they're MAD and they want to get back at someone. They get mad because they feel taken advantage of and patronized to. It's simple. Teach doctors how to talk to patients as equals, and require them to spend a little extra time with each patient, and malpractice suits will go way down.
Oh, and I totally agree with you about capping salaries and not offering extreme or cutting edge procedures unless the patient pays for it out of pocket. Except I think the capped salaries should apply to all doctors, at least all general doctors and most specialists. That might help with the patronizing attitude, too.
Lisa,
You are right, it's not my money. God gave me the ability and opportunity to make it and it is His, not the government's or the drug addict's or George Soros'. Do you know that ACORN received 8.5 billion dollars from the slammed through stimulus bill? Do you know how corrupt ACORN is? The problem with the government managing God's money is the government.
The other problem with paying for everything Obama's administration has already passed is that it has weakened the dollar, our economic position in the world, our credit and your children's and grandchildren's ability to provide for themselves. I know you don't want them to be serfs, but that is where we are headed.
OK, why not just give all your Presidents to the President now? The national debt, growing by $500 million every 9 days is a much bigger problem than universal healthcare. That has not been address and it will collapse our country. Every man woman and child in the US is born with thousands in debt owed by our government.
The proposed health care plan will NOT help the uninsured poor - the very poor already have healthcare, it's the working poor who are falling between the cracks (no money, honey). Me in particular and now the government wants to take what I've saved, my assets, in either a forced health insurance purchase or fines to implement 53 new government bureaucracies (what efficiency?) to "guarantee that all Americans have health insurance"? That is not a plan I can sign on with. I am among a large and growing group of laid off folks who have had enough of the government pretending to be God. No thank you.
So I am not going to pretend to be either an intellectual person nor a political person so don't shoot me if these are completely absurd positions. As you know I am very conservative. I am NOT however one of the people saying that I don't want my money to pay for other people's healthcare. What I am saying is that I don't want to lose MY health care that is privately insured through my husband's company. I don't understand why we can't have coverage for people that can't afford healthcare. Raise taxes to help pay for Medicare but let me continue to have my own healthcare. I also see people saying that people should not have to die because they can't afford health care and I really don't think that is a huge problem like people are making it out to be. ERs are required to treat you even if you don't have healthcare. There are plenty of nations where people are *actually* dying and I just don't see our nation as being one of them. I think that there could be health care solutions that would work better to make sure that people got health care without bankrupting our nation by making it universal health care. I am of the opinion that the govt does not always run things efficiently as private companies (I am actually very libertarian that wishes the govt would do much less that it does) so it does worry me to think of the government taking over my health care.
Okay this is the first time I have ever spoken about politics..ever. so don't shoot me. I have no idea who dumb my ideas sound. :)
When I read the story of the Good Samaritan I often think of it as being an example of how our individual Christian reaction should be to those in medical need. His words to us, His followers were to "heal the sick" in Matthew 10:8.
I am in the UK and am so grateful for our National Health Service, although when I have read some of the adverse comments from the U.S. about it I have wondered if I lived in the same country as was being described!
I really like your ideas about posting comments. i am a new for blog posting and i just like your thoughtful post. i know i am not like that what you want in posting but i,ll try to be like that but honestly, i really like your thought
Then have doctors write prescriptions not for specific drugs but for the generic drug ingredients such that the patient can decide when looking at the costs whether to take a name brand or generic drug.
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